Abstract
Only little is known about costs and effects (i.e., success) of dissemination strategies, although cost-effective dissemination strategies are crucial for the transfer of interventions into routine care. This study investigates the effects and cost-effectiveness of five school-based dissemination strategies for an Internet-based intervention for the prevention and early intervention of eating disorders. Three-hundred ninety-five schools were randomly assigned to one of five dissemination strategies. Strategies varied with respect to intensity from only sending advertisement materials and asking the school to distribute them among students to organizing presentations and workshops at schools. Effects were defined as the number of page visits, the number of screenings conducted, and the number of registrations to the Internet-based intervention. More expensive strategies proved to be more cost-effective. Cost per page visit ranged from 2.83€ (introductory presentation plus workshop) to 20.37€ (dissemination by student representatives/peers). Costs per screening ranged from 3.30€ (introductory presentation plus workshop) to 75.66€ (dissemination by student representatives/peers), and costs per registration ranged from 6.86€ (introductory presentation plus workshop) to 431.10€ (advertisement materials only). Dissemination of an Internet-based intervention for prevention and early intervention is challenging and expensive. More intense, expensive strategies with personal contact proved to be more cost-effective. The combination of an introductory presentation on eating disorders and a workshop in the high school was most effective and had the best cost-effectiveness ratio. The sole distribution of advertisement materials attracted hardly any participants to the Internet-based program.
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Notes
It is important to note that these schools are no study drop-outs. In contrast to efficacy trials, in this study, the willingness to participate is part of the effect/success of the respective dissemination strategy. Therefore, all costs related to approaching these schools were included in the analyses even though there was no effect of the respective strategy in these schools.
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Funding
This work was supported by the project ProYouth which received funding from the European Union, in the framework of the Health Programme (PROYOUTH 20101209).
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The authors declare that they have no competing interests.
Ethical Approval
The efficacy study was approved by the Ethics Committee of the Medical Faculty of the University of Heidelberg (S-236/2008). According to the Ethics Committee, separate approval for the dissemination of the program was not needed.
Informed Consent
All participants registering to the ProYouth program provide informed consent online. For the present study, no personal data were gathered, i.e., only anonymous data were used.
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Moessner, M., Minarik, C., Ozer, F. et al. Effectiveness and Cost-effectiveness of School-based Dissemination Strategies of an Internet-based Program for the Prevention and Early Intervention in Eating Disorders: A Randomized Trial. Prev Sci 17, 306–313 (2016). https://doi.org/10.1007/s11121-015-0619-y
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DOI: https://doi.org/10.1007/s11121-015-0619-y